Demo

Senior Claims Specialist

HashRoot
Orange, CA Full Time
POSTED ON 12/29/2025
AVAILABLE BEFORE 1/29/2026

Job Title: Medical Malpractice Claims Specialist

Location: Orange County, CA — Onsite

Experience Required: 3 years

Salary Range: $110,000 – $130,000 per year

Employment Type: Full-Time


Position Overview

We are seeking a highly skilled Medical Malpractice Claims Specialist to join our Orange County team. This role is responsible for handling complex medical malpractice claim files, overseeing litigation activities, and supporting ongoing training and mentorship of junior Claims Specialists. The ideal candidate is analytical, detail-oriented, and capable of managing high-exposure cases with professionalism and accuracy.


Key Responsibilities

  • Manage assigned medical malpractice claim files from initial evaluation to resolution
  • Direct and oversee defense counsel in compliance with Claims Technical Manual and Defense Attorney Guidelines
  • Evaluate cases by interviewing members, reviewing medical records, and securing expert opinions
  • Prepare and present case evaluation reports for CRC and CSC review
  • Manage litigation activities including discovery planning, mediation, MSC, and negotiations when required
  • Monitor arbitration and provide daily progress reporting to defense counsel and members
  • Ensure timely and accurate updates to the claims database
  • Document all critical case developments, coding updates, and indexing through OnBase
  • Prepare comprehensive claim file resolution documentation
  • Support and mentor Claims Specialist I & II team members as part of continued training initiatives


Required Qualifications

  • Bachelor’s degree from a four-year accredited institution
  • Background in medical or legal field strongly preferred
  • 5 years of medical malpractice claims management experience OR 3 years general claims experience
  • Proven ability to handle complex, high-exposure claim caseloads
  • Strong investigative, analytical, and written communication skills


What We’re Looking For

Candidates with strong judgment, attention to detail, legal understanding, and the ability to handle sensitive and high-risk litigation matters. Someone who thrives in a fast-paced, detail-driven environment and adds value through expertise and leadership.

Salary : $110,000 - $130,000

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